Oligomer-Anticholinergic Agent Conjugates

ABSTRACT

The invention provides small molecule drugs that are chemically modified by covalent attachment of a water-soluble oligomer. A conjugate of the invention, when administered by any of a number of administration routes, exhibits characteristics that are different as compared to the characteristics of the small molecule drug not attached to the water-soluble oligomer.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.12/530,424, filed Feb. 17, 2010, which application is a national phasefiling under 35 U.S.C. §371 of International Patent Application No.PCT/US2008/003296, filed Mar. 12, 2008, which application claims thebenefit of priority under 35. U.S.C. §119(e) of U.S. ProvisionalApplication Ser. No. 60/906,329, filed Mar. 12, 2007, this disclosuresof all of which are incorporated herein by reference.

FIELD OF THE INVENTION

This invention provides (among other things) chemically modified smallmolecule anticholinergic agents that possess certain advantages oversmall molecule anticholinergic agents lacking the chemical modification.The chemically modified small molecule anticholinergic agents describedherein relate to and/or have application(s) in (among others) the fieldsof drug discovery, pharmacotherapy, physiology, organic chemistry andpolymer chemistry.

BACKGROUND OF THE INVENTION

The spasmolytic effects of anticholinergic agents acting on muscarinicreceptors have been used for the treatment of patients suffering fromurgency, frequency, urinary leakage, urge incontinence, and dysuria,among other maladies. It is believed these agents exert a nonspecificdirect relaxant effect on smooth muscle. As a consequence,administration of these muscarinic receptor antagonists results indecrease spasm of the gastrointestinal tract, biliary tract, ureter, anduterus.

The broad range of pharmacological activity of anticholinergic agents,however, often results in deleterious effects. For example,administration of oxybutynin—which is indicated for bladderinstability—is associated with dizziness and somnolence. In addition,use of anticholinergic agents by patients is often associated with drymouth.

It may be that one or more side effects (such as dizziness andsomnolence) associated with the administration of anticholinergic agentsis the result of the anticholinergic agent reaching the central nervoussystem. Thus, it would advantageous to have an anticholinergic agentthat maintained its peripheral effects yet was able to avoid reachingthe central nervous system.

The present invention seeks to address this and other needs in the art.

SUMMARY OF THE INVENTION

In one or more embodiments, a compound is provided, the compoundcomprising a residue of an anticholinergic agent covalently attached,either directly or through one or more atoms, (preferably via a stablelinkage) to a water-soluble, non-peptidic oligomer.

In one or more embodiments, a compound is provided, the compoundcomprising a residue of an anticholinergic agent covalently attached,either directly or through one or more atoms, (preferably via a stablelinkage) to a water-soluble, non-peptidic oligomer, wherein theanticholinergic agent is encompassed by the following formula:

wherein:

R¹ is selected from the group consisting of H, OH, and an organicradical, preferably R¹ is selected from the group consisting of —H, —OH,—CH₂OH, —CH₃, cyclopentyl, 1-hydroxyl cyclopentyl, cyclohexyl, andaromatic-containing organic radical (such as phenyl);

either (i) R² is selected from the group consisting of —H, —OH, and anorganic radical [preferably R² is selected from the group consisting of—H, —OH, —CH₂OH, —CH₃, cyclopentyl, 1-hydroxyl cyclopentyl, cyclohexyl,and aromatic-containing organic radical (such as phenyl)], and R³ isselected from the group consisting of H, OH, and an organic radical,[preferably R³ is selected from the group consisting of —H, —OH, —CH₂OH,—CH₃, cyclopentyl, 1-hydroxyl cyclopentyl, cyclohexyl, andaromatic-containing organic radical (such as phenyl)], or (ii) R² and R³are combined to form a cyclo, such as a cyclohexyl;

with the proviso that at least one of R¹ and R³ is anaromatic-containing organic radical (such as phenyl);

L¹ is —O—, —C(O)O—, —OC(O)—, —C(O)—;

L² is a C₂₋₄-containing hydrocarbon linker, heterocyclo (incorporatingthe N of Formula I), biheterocyclo (incorporating the N of Formula I);

R⁴ is an organic radical, preferably —CH₃ or —CH₂CH₃; and

R⁵ is an organic radical, preferably CH₃ or CH₂CH₃, and further whereinthe amine of Formula I is optionally charged (e.g., a quaternarynitrogen as a result of a CH₃ group being bound to the amine).

In one or more embodiments of the invention, a composition is provided,the composition comprising a compound comprising a residue of ananticholinergic agent covalently attached, either directly or throughone or more atoms, (preferably via a stable linkage) to a water-soluble,non-peptidic oligomer; and, optionally, a pharmaceutically acceptableexcipient.

In one or more embodiments of the invention, a dosage form is provided,the dosage form comprising a compound comprising a residue of ananticholinergic agent covalently attached, either directly or throughone or more atoms, (preferably via a stable linkage) to a water-soluble,non-peptidic oligomer

In one or more embodiments of the invention, a method is provided, themethod comprising covalently attaching a water-soluble, non-peptidicoligomer to a small molecule anticholinergic agent.

In one or more embodiments of the invention, a method is provided, themethod comprising administering a compound comprising a residue of ananticholinergic agent covalently attached, either directly or throughone or more atoms, (preferably via a stable linkage), to awater-soluble, non-peptidic oligomer.

These and other objects, aspects, embodiments and features of theinvention will become more fully apparent when read in conjunction withthe following detailed description.

DETAILED DESCRIPTION OF THE INVENTION

It must be noted that, as used in this specification, the singular forms“a,” “an,” and “the” include plural referents unless the context clearlydictates otherwise.

In describing and claiming the present invention, the followingterminology will be used in accordance with the definitions describedbelow.

“Water soluble, non-peptidic oligomer” indicates an oligomer that is atleast 35% (by weight) soluble, preferably greater than 70% (by weight),and more preferably greater than 95% (by weight) soluble, in water atroom temperature. Typically, an unfiltered aqueous preparation of a“water-soluble” oligomer transmits at least 75%, more preferably atleast 95%, of the amount of light transmitted by the same solution afterfiltering. It is most preferred, however, that the water-solubleoligomer is at least 95% (by weight) soluble in water or completelysoluble in water. With respect to being “non-peptidic,” an oligomer isnon-peptidic when it has less than 35% (by weight) of amino acidresidues.

The terms “monomer,” “monomeric subunit” and “monomeric unit” are usedinterchangeably herein and refer to one of the basic structural units ofa polymer or oligomer. In the case of a homo-oligomer, a singlerepeating structural unit forms the oligomer. In the case of aco-oligomer, two or more structural units are repeated—either in apattern or randomly—to form the oligomer. Preferred oligomers used inconnection with present the invention are homo-oligomers. Thewater-soluble, non-peptidic oligomer typically comprises one or moremonomers serially attached to form a chain of monomers. The oligomer canbe formed from a single monomer type (i.e., is homo-oligomeric) or twoor three monomer types (i.e., is co-oligomeric).

An “oligomer” is a molecule possessing from about 2 to about 50monomers, preferably from about 2 to about 30 monomers. The architectureof an oligomer can vary. Specific oligomers for use in the inventioninclude those having a variety of geometries such as linear, branched,or forked, to be described in greater detail below.

“PEG” or “polyethylene glycol,” as used herein, is meant to encompassany water-soluble poly(ethylene oxide). Unless otherwise indicated, a“PEG oligomer” (also called an oligoethylene glycol) is one in whichsubstantially all (and more preferably all) monomeric subunits areethylene oxide subunits. The oligomer may, however, contain distinct endcapping moieties or functional groups, e.g., for conjugation. Typically,PEG oligomers for use in the present invention will comprise one of thetwo following structures: “—(CH₂CH₂O)_(n)—” or“—(CH₂CH₂O)_(n-1)CH₂CH₂—,” depending upon whether the terminal oxygen(s)has been displaced, e.g., during a synthetic transformation. For PEGoligomers, “n” varies from about 2 to 50, preferably from about 2 toabout 30, and the terminal groups and architecture of the overall PEGcan vary. When PEG further comprises a functional group, A, for linkingto, e.g., a small molecule drug, the functional group when covalentlyattached to a PEG oligomer does not result in formation of (i) anoxygen-oxygen bond (—O—O—, a peroxide linkage), or (ii) anitrogen-oxygen bond (N—O, O—N).

An “end capping group” is generally a non-reactive carbon-containinggroup attached to a terminal oxygen of a PEG oligomer. Exemplary endcapping groups comprise a C₁₋₅ alkyl group, such as methyl, ethyl andbenzyl), as well as aryl, heteroaryl, cyclo, heterocyclo, and the like.For the purposes of the present invention, the preferred capping groupshave relatively low molecular weights such as methyl or ethyl. Theend-capping group can also comprise a detectable label. Such labelsinclude, without limitation, fluorescers, chemiluminescers, moietiesused in enzyme labeling, colorimetric labels (e.g., dyes), metal ions,and radioactive moieties.

“Branched”, in reference to the geometry or overall structure of anoligomer, refers to an oligomer having two or more polymers representingdistinct “arms” that extend from a branch point.

“Forked” in reference to the geometry or overall structure of anoligomer, refers to an oligomer having two or more functional groups(typically through one or more atoms) extending from a branch point.

A “branch point” refers to a bifurcation point comprising one or moreatoms at which an oligomer branches or forks from a linear structureinto one or more additional arms.

The term “reactive” or “activated” refers to a functional group thatreacts readily or at a practical rate under conventional conditions oforganic synthesis. This is in contrast to those groups that either donot react or require strong catalysts or impractical reaction conditionsin order to react (i.e., a “nonreactive” or “inert” group).

“Not readily reactive,” with reference to a functional group present ona molecule in a reaction mixture, indicates that the group remainslargely intact under conditions that are effective to produce a desiredreaction in the reaction mixture.

A “protecting group” is a moiety that prevents or blocks reaction of aparticular chemically reactive functional group in a molecule undercertain reaction conditions. The protecting group will vary dependingupon the type of chemically reactive group being protected as well asthe reaction conditions to be employed and the presence of additionalreactive or protecting groups in the molecule. Functional groups whichmay be protected include, by way of example, carboxylic acid groups,amino groups, hydroxyl groups, thiol groups, carbonyl groups and thelike. Representative protecting groups for carboxylic acids includeesters (such as a p-methoxybenzyl ester), amides and hydrazides; foramino groups, carbamates (such as tert-butoxycarbonyl) and amides; forhydroxyl groups, ethers and esters; for thiol groups, thioethers andthioesters; for carbonyl groups, acetals and ketals; and the like. Suchprotecting groups are well-known to those skilled in the art and aredescribed, for example, in T. W. Greene and G. M. Wuts, ProtectingGroups in Organic Synthesis, Third Edition, Wiley, New York, 1999, andreferences cited therein.

A functional group in “protected form” refers to a functional groupbearing a protecting group. As used herein, the term “functional group”or any synonym thereof encompasses protected forms thereof.

A “physiologically cleavable” or “hydrolyzable” or “degradable” bond isa relatively labile bond that reacts with water (i.e., is hydrolyzed)under ordinary physiological conditions. The tendency of a bond tohydrolyze in water under ordinary physiological conditions will dependnot only on the general type of linkage connecting two central atoms butalso on the substituents attached to these central atoms. Such bonds aregenerally recognizable by those of ordinary skill in the art.Appropriate hydrolytically unstable or weak linkages include but are notlimited to carboxylate ester, phosphate ester, anhydrides, acetals,ketals, acyloxyalkyl ether, imines, orthoesters, peptides,oligonucleotides, thioesters, and carbonates.

An “enzymatically degradable linkage” means a linkage that is subject todegradation by one or more enzymes under ordinary physiologicalconditions.

A “stable” linkage or bond refers to a chemical moiety or bond,typically a covalent bond, that is substantially stable in water, thatis to say, does not undergo hydrolysis under ordinary physiologicalconditions to any appreciable extent over an extended period of time.Examples of hydrolytically stable linkages include but are not limitedto the following: carbon-carbon bonds (e.g., in aliphatic chains),ethers, amides, urethanes, amines, and the like. Generally, a stablelinkage is one that exhibits a rate of hydrolysis of less than about1-2% per day under ordinary physiological conditions. Hydrolysis ratesof representative chemical bonds can be found in most standard chemistrytextbooks.

In the context of describing the consistency of oligomers in a givencomposition, “substantially” or “essentially” means nearly totally orcompletely, for instance, 95% or greater, more preferably 97% orgreater, still more preferably 98% or greater, even more preferably 99%or greater, yet still more preferably 99.9% or greater, with 99.99% orgreater being most preferred of some given quantity.

“Monodisperse” refers to an oligomer composition wherein substantiallyall of the oligomers in the composition have a well-defined, singlemolecular weight and defined number of monomers, as determined bychromatography or mass spectrometry. Monodisperse oligomer compositionsare in one sense pure, that is, substantially comprising moleculeshaving a single and definable number of monomers rather than severaldifferent numbers of monomers (i.e., an oligomer composition havingthree or more different oligomer sizes). A monodisperse oligomercomposition possesses a MW/Mn value of 1.0005 or less, and morepreferably, a MW/Mn value of 1.0000. By extension, a compositioncomprised of monodisperse conjugates means that substantially alloligomers of all conjugates in the composition have a single anddefinable number (as a whole number) of monomers rather than adistribution and would possess a MW/Mn value of 1.0005, and morepreferably, a MW/Mn value of 1.0000 if the oligomer were not attached tothe residue of an anticholinergic agent. A composition comprised ofmonodisperse conjugates can include, however, one or more nonconjugatesubstances such as solvents, reagents, excipients, and so forth.

“Bimodal,” in reference to an oligomer composition, refers to anoligomer composition wherein substantially all oligomers in thecomposition have one of two definable and different numbers (as wholenumbers) of monomers rather than a distribution, and whose distributionof molecular weights, when plotted as a number fraction versus molecularweight, appears as two separate identifiable peaks. Preferably, for abimodal oligomer composition as described herein, each peak is generallysymmetric about its mean, although the size of the two peaks may differ.Ideally, the polydispersity index of each peak in the bimodaldistribution, Mw/Mn, is 1.01 or less, more preferably 1.001 or less, andeven more preferably 1.0005 or less, and most preferably a MW/Mn valueof 1.0000. By extension, a composition comprised of bimodal conjugatesmeans that substantially all oligomers of all conjugates in thecomposition have one of two definable and different numbers (as wholenumbers) of monomers rather than a large distribution and would possessa MW/Mn value of 1.01 or less, more preferably 1.001 or less and evenmore preferably 1.0005 or less, and most preferably a MW/Mn value of1.0000 if the oligomer were not attached to the small moleculeanticholinergic. A composition comprised of bimodal conjugates caninclude, however, one or more nonconjugate substances such as solvents,reagents, excipients, and so forth.

An “anticholinergic agent” is broadly used herein to refer to anorganic, inorganic, or organometallic compound typically having amolecular weight of less than about 1000 Daltons (and typically lessthan 500 Daltons) and having some degree of activity as ananticholinergic agent. Small molecule anticholinergic agents encompassoligopeptides and other biomolecules having a molecular weight of lessthan about 1000.

A “biological membrane” is any membrane, typically made from specializedcells or tissues, that serves as a barrier to at least some foreignentities or otherwise undesirable materials. As used herein a“biological membrane” includes those membranes that are associated withphysiological protective barriers including, for example: theblood-brain barrier (BBB); the blood-cerebrospinal fluid barrier; theblood-placental barrier; the blood-milk barrier; the blood-testesbarrier; and mucosal barriers including the vaginal mucosa, urethralmucosa, anal mucosa, buccal mucosa, sublingual mucosa, rectal mucosa,and so forth. Unless the context clearly dictates otherwise, the term“biological membrane” does not include those membranes associated withthe middle gastro-intestinal tract (e.g., stomach and small intestines).

A “biological membrane crossing rate,” as used herein, provides ameasure of a compound's ability to cross a biological membrane (such asthe membrane associated with the blood-brain barrier). A variety ofmethods can be used to assess transport of a molecule across any givenbiological membrane. Methods to assess the biological membrane crossingrate associated with any given biological barrier (e.g., theblood-cerebrospinal fluid barrier, the blood-placental barrier, theblood-milk barrier, the intestinal barrier, and so forth), are known inthe art, described herein and/or in the relevant literature, and/or canbe determined by one of ordinary skill in the art.

A “reduced rate of metabolism” in reference to the present invention,refers to a measurable reduction in the rate of metabolism of awater-soluble oligomer-small molecule drug conjugate as compared to rateof metabolism of the small molecule drug not attached to thewater-soluble oligomer (i.e., the small molecule drug itself) or areference standard material. In the special case of “reduced first passrate of metabolism,” the same “reduced rate of metabolism” is requiredexcept that the small molecule drug (or reference standard material) andthe corresponding conjugate are administered orally. Orally administereddrugs are absorbed from the gastro-intestinal tract into the portalcirculation and must pass through the liver prior to reaching thesystemic circulation. Because the liver is the primary site of drugmetabolism or biotransformation, a substantial amount of drug can bemetabolized before it ever reaches the systemic circulation. The degreeof first pass metabolism, and thus, any reduction thereof, can bemeasured by a number of different approaches. For instance, animal bloodsamples can be collected at timed intervals and the plasma or serumanalyzed by liquid chromatography/mass spectrometry for metabolitelevels. Other techniques for measuring a “reduced rate of metabolism”associated with the first pass metabolism and other metabolic processesare known in the art, described herein and/or in the relevantliterature, and/or can be determined by one of ordinary skill in theart. Preferably, a conjugate of the invention can provide a reduced rateof metabolism reduction satisfying at least one of the following values:at least about 30%; at least about 40%; at least about 50%; at leastabout 60%; at least about 70%; at least about 80%; and at least about90%. A compound (such as a small molecule drug or conjugate thereof)that is “orally bioavailable” is one that preferably possesses abioavailability when administered orally of greater than 25%, andpreferably greater than 70%, where a compound's bioavailability is thefraction of administered drug that reaches the systemic circulation inunmetabolized form.

“Alkyl” refers to a hydrocarbon chain, typically ranging from about 1 to20 atoms in length. Such hydrocarbon chains are preferably but notnecessarily saturated and may be branched or straight chain, althoughtypically straight chain is preferred. Exemplary alkyl groups includemethyl, ethyl, propyl, butyl, pentyl, 1-methylbutyl, 1-ethylpropyl,3-methylpentyl, and the like. As used herein, “alkyl” includescycloalkyl when three or more carbon atoms are referenced. An “alkenyl”group is an alkyl of 2 to 20 carbon atoms with at least onecarbon-carbon double bond.

The terms “substituted alkyl” or “substituted C_(q-r) alkyl” where q andr are integers identifying the range of carbon atoms contained in thealkyl group, denotes the above alkyl groups that are substituted by one,two or three halo (e.g., F, Cl, Br, I), trifluoromethyl, hydroxy, C₁₋₇alkyl (e.g., methyl, ethyl, n-propyl, isopropyl, butyl, t-butyl, and soforth), C₁₋₇ alkoxy, C₁₋₇ acyloxy, C₃₋₇ heterocyclic, amino, phenoxy,nitro, carboxy, carboxy, acyl, cyano. The substituted alkyl groups maybe substituted once, twice or three times with the same or withdifferent substituents.

“Lower alkyl” refers to an alkyl group containing from 1 to 6 carbonatoms, and may be straight chain or branched, as exemplified by methyl,ethyl, n-butyl, i-butyl, t-butyl. “Lower alkenyl” refers to a loweralkyl group of 2 to 6 carbon atoms having at least one carbon-carbondouble bond.

“Non-interfering substituents” are those groups that, when present in amolecule, are typically non-reactive with other functional groupscontained within the molecule.

“Alkoxy” refers to an —O—R group, wherein R is alkyl or substitutedalkyl, preferably C₁-C₂₀ alkyl (e.g., methoxy, ethoxy, propyloxy,benzyl, etc.), preferably C₁-C₇.

“Pharmaceutically acceptable excipient” or “pharmaceutically acceptablecarrier” refers to component that can be included in the compositions ofthe invention in order to provide for a composition that has anadvantage (e.g., more suited for administration to a patient) over acomposition lacking the component and that is recognized as not causingsignificant adverse toxicological effects to a patient.

The term “aryl” means an aromatic group having up to 14 carbon atoms.Aryl groups include phenyl, naphthyl, biphenyl, phenanthrenyl,naphthacenyl, and the like. “Substituted phenyl” and “substituted aryl”denote a phenyl group and aryl group, respectively, substituted withone, two, three, four or five (e.g. 1-2, 1-3 or 1-4 substituents) chosenfrom halo (F, Cl, Br, I), hydroxy, hydroxy, cyano, nitro, alkyl (e.g.,C₁₋₆ alkyl), alkoxy (e.g., C₁₋₆ alkoxy), benzyloxy, carboxy, aryl, andso forth.

An “aromatic-containing moiety” is a collection of atoms containing atleast aryl and optionally one or more atoms. Suitablearomatic-containing moieties are described herein below.

For simplicity, chemical moieties are defined and referred to throughoutprimarily as univalent chemical moieties (e.g., alkyl, aryl, etc.).Nevertheless, such terms are also used to convey correspondingmultivalent moieties under the appropriate structural circumstancesclear to those skilled in the art. For example, while an “alkyl” moietygenerally refers to a monovalent radical (e.g., CH₃—CH₂—), in certaincircumstances a bivalent linking moiety can be “alkyl,” in which casethose skilled in the art will understand the alkyl to be a divalentradical (e.g., —CH₂—CH₂—), which is equivalent to the term “alkylene.”(Similarly, in circumstances in which a divalent moiety is required andis stated as being “aryl,” those skilled in the art will understand thatthe term “aryl” refers to the corresponding divalent moiety, arylene).All atoms are understood to have their normal number of valences forbond formation (i.e., 4 for carbon, 3 for N, 2 for O, and 2, 4, or 6 forS, depending on the oxidation state of the S).

“Pharmacologically effective amount,” “physiologically effectiveamount,” and “therapeutically effective amount” are used interchangeablyherein to mean the amount of a water-soluble oligomer-small moleculedrug conjugate present in a composition that is needed to provide athreshold level of active agent and/or conjugate in the bloodstream orin the target tissue. The precise amount will depend upon numerousfactors, e.g., the particular active agent, the components and physicalcharacteristics of the composition, intended patient population, patientconsiderations, and the like, and can readily be determined by oneskilled in the art, based upon the information provided herein andavailable in the relevant literature.

A “difunctional” oligomer is an oligomer having two functional groupscontained therein, typically at its termini. When the functional groupsare the same, the oligomer is said to be homodifunctional. When thefunctional groups are different, the oligomer is said to beheterobifunctional.

A basic reactant or an acidic reactant described herein include neutral,charged, and any corresponding salt forms thereof.

The term “patient,” refers to a living organism suffering from or proneto a condition that can be prevented or treated by administration of aconjugate as described herein, typically, but not necessarily, in theform of a water-soluble oligomer-small molecule drug conjugate, andincludes both humans and animals.

“Optional” or “optionally” means that the subsequently describedcircumstance may but need not necessarily occur, so that the descriptionincludes instances where the circumstance occurs and instances where itdoes not.

As indicated above, the present invention is directed to (among otherthings) a compound comprising a residue of an anticholinergic agentcovalently attached, either directly or through one or more atoms,(preferably) via a stable linkage to a water-soluble, non-peptidicoligomer.

In one or more embodiments of the invention, a compound is provided, thecompound comprising a residue of an anticholinergic agent covalentlyattached via a stable or degradable linkage to a water-soluble,non-peptidic oligomer, wherein the anticholinergic agent has a structureencompassed by the following formula:

wherein:

R¹ is selected from the group consisting of H, OH, and an organicradical, preferably R¹ is selected from the group consisting of —H, —OH,—CH₂OH, —CH₃, cyclopentyl, 1-hydroxyl cyclopentyl, cyclohexyl, andaromatic-containing organic radical (such as phenyl);

either (i) R² is selected from the group consisting of —H, —OH, and anorganic radical [preferably R² is selected from the group consisting of—H, —OH, —CH₂OH, —CH₃, cyclopentyl, 1-hydroxyl cyclopentyl, cyclohexyl,and aromatic-containing organic radical (such as phenyl)], and R³ isselected from the group consisting of H, OH, and an organic radical,[preferably R³ is selected from the group consisting of —H, —OH, —CH₂OH,—CH₃, cyclopentyl, 1-hydroxyl cyclopentyl, cyclohexyl, andaromatic-containing organic radical (such as phenyl)], or (ii) R² and R³are combined to form a cyclo, such as a cyclohexyl;

with the proviso that at least one of R¹ and R³ is anaromatic-containing organic radical (such as phenyl);

L¹ is —O—, —C(O)O—, —OC(O)—, —C(O)—;

L² is a C₂₋₄-containing hydrocarbon linker, heterocyclo (incorporatingthe N of Formula I), biheterocyclo (incorporating the N of Formula I);

R⁴ is an organic radical, preferably —CH₃ or —CH₂CH₃; and

R⁵ is an organic radical, preferably CH₃ or CH₂CH₃, and further whereinthe amine of Formula I is optionally charged (e.g., a quaternarynitrogen as a result of a CH₃ group being bound to the amine).

Examples of specific anticholinergic agents that are muscarinic receptorantagonists include those selected from the group consisting ofoxybutynin, dicyclomine, oxyphencyclimine, flavoxate, clindium,cyclopentolate, eucatropine, glycopyrrolate, mepanzolate, methantheline,scopolamine, atropine and propantheline.

It is believed that an advantage of attaching a water-soluble,non-peptidic oligomer to, for example, the amine group of ananticholinergic agent (e.g., effectively “substituting” an alkyl groupattached to an amine for a water-soluble, non-peptidic oligomer for) mayresult in reduction of side effects. Without wishing to be bound bytheory, it is believed that—with respect to the representativeanticholinergic agent oxybutynin—the frequently encountered side effectof dry mouth is caused by metabolism at the diethyl amine group. Becauseattaching a water-soluble, non-peptidic oligomer to this amine group isexpected to prevent (and/or reduce) the formation of the drymouth-causing metabolite, compounds of the invention having awater-soluble, non-peptidic oligomer attached at or near this locationare expected to alleviate or reduce this side effect.

It is also believed that an advantage of the conjugates of the presentinvention is their ability to retain some degree of muscarinic receptorantagonism while not inducing clinically meaningful drowsiness. Althoughnot wishing to be bound by theory, the extra size introduced by theoligomer—in contrast to the unconjugated “original” anticholinergicagent—reduces the ability of the compound to cross the blood-brainbarrier. In this way, the antimuscarinic effects of the conjugate canact within the periphery while avoiding the central nervous system (andthereby avoid central nervous system-mediated side effects). Theconjugates of the present invention may have other benefits as well.

Use of discrete oligomers (e.g., from a monodisperse or bimodalcomposition of oligomers, in contrast to relatively impure compositions)to form conjugates can advantageously alter certain propertiesassociated with the corresponding small molecule drug. For instance, aconjugate of the invention, when administered by any of a number ofsuitable administration routes, such as parenteral, oral, transdermal,buccal, pulmonary, or nasal, exhibits reduced penetration across theblood-brain barrier. It is preferred that the conjugates exhibit slowed,minimal or effectively no crossing of the blood-brain barrier, whilestill crossing the gastro-intestinal (GI) walls and into the systemiccirculation if oral delivery is intended. Moreover, the conjugates ofthe invention maintain a degree of bioactivity as well asbioavailability in their conjugated form.

With respect to the blood-brain barrier (“BBB”), this barrier restrictsthe transport of drugs from the blood to the brain. This barrierconsists of a continuous layer of unique endothelial cells joined bytight junctions. The cerebral capillaries, which comprise more than 95%of the total surface area of the BBB, represent the principal route forthe entry of most solutes and drugs into the central nervous system.

For compounds whose degree of blood-brain barrier crossing ability isnot readily known, such ability can be determined using a suitableanimal model. In addition, the degree of blood-brain barrier crossingcan be determined using an in situ rat brain perfusion (“RBP”) model asdescribed herein. Briefly, the RBP technique involves cannulation of thecarotid artery followed by perfusion with a compound solution undercontrolled conditions, followed by a wash out phase to remove compoundremaining in the vascular space. (Such analyses can be conducted, forexample, by contract research organizations such as Absorption Systems,Exton, Pa.). More specifically, in the RBP model, a cannula is placed inthe left carotid artery and the side branches are tied off. Aphysiologic buffer containing the compound (5 micromolar) is perfused ata flow rate of 10 mL/minute in a single pass perfusion experiment. After30 seconds, the perfusion is stopped and the brain vascular contents arewashed out with compound-free buffer for an additional 30 seconds. Thebrain tissue is then removed and analyzed for compound concentrationsvia liquid chromatograph with tandem mass spectrometry detection(LC/MS/MS). Alternatively, blood-brain barrier permeability can beestimated based upon a calculation of the compound's molecular polarsurface area (“PSA”), which is defined as the sum of surfacecontributions of polar atoms (usually oxygens, nitrogens and attachedhydrogens) in a molecule. The PSA has been shown to correlate withcompound transport properties such as blood-brain barrier transport.Methods for determining a compound's PSA can be found, e.g., in, Ertl,P., et al., J. Med. Chem. 2000, 43, 3714-3717; and Kelder, J., et al.,Pharm. Res. 1999, 16, 1514-1519.

With respect to the blood-brain barrier, the water-solubleoligomer-small molecule drug conjugate exhibits a blood-brain barriercrossing rate that is reduced as compared to the crossing rate of thesmall molecule drug not attached to the water-soluble oligomer.Exemplary reductions in blood-brain barrier crossing rates for theconjugates described herein include reductions of: at least about 5%; atleast about 10%; at least about 25%; at least about 30%; at least about40%; at least about 50%; at least about 60%; at least about 70%; atleast about 80%; or at least about 90%, when compared to the blood-brainbarrier crossing rate of the small molecule drug not attached to thewater-soluble oligomer. A preferred reduction in the blood-brain barriercrossing rate for a conjugate is at least about 20%.

As indicated above, the compounds of the invention include a residue ofan anticholinergic agent. Assays for determining whether a givencompound (regardless of whether the compound is in conjugated form ornot) can block muscarinic receptors are described infra.

In some instances, anticholinergic agents can be obtained fromcommercial sources. In addition, anticholinergic agents can be obtainedthrough chemical synthesis. Synthetic approaches for preparinganticholinergic agents are described in the literature.

Each of these (and other) anticholinergic agents can be covalentlyattached (either directly or through one or more atoms) to awater-soluble, non-peptidic oligomer.

The anticholingeric agent is a small molecule drug and generally has amolecular weight of less than 1000 Da. Exemplary molecular weights ofsmall molecule drugs include molecular weights of: less than about 950;less than about 900; less than about 850; less than about 800; less thanabout 750; less than about 700; less than about 650; less than about600; less than about 550; less than about 500; less than about 450; lessthan about 400; less than about 350; and less than about 300.

Small molecule drugs, for the purpose of the invention, includeoligopeptides, oligonucleotides, and other biomolecules having amolecular weight of less than about 1000 Daltons. Also encompassed inthe term “small molecule drug” is any fragment of a peptide, protein orantibody, including native sequences and variants falling within themolecular weight range stated above. In one or more embodiments,however, it is preferred that the small molecule drug satisfies one ormore of the following: not an oligopeptide; not an oligonucleotide; notan antibody; and not a fragment of any of the foregoing.

The small molecule drug used in the invention, if chiral, may be in aracemic mixture, or an optically active form, for example, a singleoptically active enantiomer, or any combination or ratio of enantiomers(i.e., scalemic mixture). In addition, the small molecule drug maypossess one or more geometric isomers. With respect to geometricisomers, a composition can comprise a single geometric isomer or amixture of two or more geometric isomers. A small molecule drug for usein the present invention can be in its customary active form, or maypossess some degree of modification. For example, a small molecule drugmay have a targeting agent, tag, or transporter attached thereto, priorto or after covalent attachment of an oligomer. Alternatively, the smallmolecule drug may possess a lipophilic moiety attached thereto, such asa phospholipid (e.g., distearoylphosphatidylethanolamine or “DSPE,”dipalmitoylphosphatidylethanolamine or “DPPE,” and so forth) or a smallfatty acid. In some instances, however, it is preferred that the smallmolecule drug moiety does not include attachment to a lipophilic moiety.

The anticholinergic agent for coupling to a water-soluble, non-peptidicoligomer possesses a free hydroxyl, carboxyl, thio, amino group, or thelike (i.e., “handle”) suitable for covalent attachment to the oligomer.In addition, the anticholinergic agent can be modified by introductionof a reactive group, preferably by conversion of one of its existingfunctional groups to a functional group suitable for formation of acovalent linkage between the oligomer and the drug.

Accordingly, each oligomer is composed of up to three different monomertypes selected from the group consisting of: alkylene oxide, such asethylene oxide or propylene oxide; olefinic alcohol, such as vinylalcohol, 1-propenol or 2-propenol; vinyl pyrrolidone; hydroxyalkylmethacrylamide or hydroxyalkyl methacrylate, where alkyl is preferablymethyl; α-hydroxy acid, such as lactic acid or glycolic acid;phosphazene, oxazoline, amino acids, carbohydrates such asmonosaccharides, saccharide or mannitol; and N-acryloylmorpholine.Preferred monomer types include alkylene oxide, olefinic alcohol,hydroxyalkyl methacrylamide or methacrylate, N-acryloylmorpholine, andα-hydroxy acid. Preferably, each oligomer is, independently, aco-oligomer of two monomer types selected from this group, or, morepreferably, is a homo-oligomer of one monomer type selected from thisgroup.

The two monomer types in a co-oligomer may be of the same monomer type,for example, two alkylene oxides, such as ethylene oxide and propyleneoxide. Preferably, the oligomer is a homo-oligomer of ethylene oxide.Usually, although not necessarily, the terminus (or termini) of theoligomer that is not covalently attached to a small molecule is cappedto render it unreactive. Alternatively, the terminus may include areactive group. When the terminus is a reactive group, the reactivegroup is either selected such that it is unreactive under the conditionsof formation of the final oligomer or during covalent attachment of theoligomer to a small molecule drug, or it is protected as necessary. Onecommon end-functional group is hydroxyl or —OH, particularly foroligoethylene oxides.

The two monomer types in a co-oligomer may be of the same monomer type,for example, two alkylene oxides, such as ethylene oxide and propyleneoxide. Preferably, the oligomer is a homo-oligomer of ethylene oxide.Usually, although not necessarily, the terminus (or termini) of theoligomer that is not covalently attached to a small molecule is cappedto render it unreactive. Alternatively, the terminus may include areactive group. When the terminus is a reactive group, the reactivegroup is either selected such that it is unreactive under the conditionsof formation of the final oligomer or during covalent attachment of theoligomer to a small molecule drug, or it is protected as necessary. Onecommon end-functional group is hydroxyl or —OH, particularly foroligoethylene oxides.

The water-soluble, non-peptidic oligomer (e.g., “POLY” in variousstructures provided herein) can have any of a number of differentgeometries. For example, it can be linear, branched, or forked. Mosttypically, the water-soluble, non-peptidic oligomer is linear or isbranched, for example, having one branch point. Although much of thediscussion herein is focused upon polyethylene oxide) as an illustrativeoligomer, the discussion and structures presented herein can be readilyextended to encompass any of the water-soluble, non-peptidic oligomersdescribed above.

The molecular weight of the water-soluble, non-peptidic oligomer,excluding the linker portion, is generally relatively low. Exemplaryvalues of the molecular weight of the water-soluble polymer include:below about 1500; below about 1450; below about 1400; below about 1350;below about 1300; below about 1250; below about 1200; below about 1150;below about 1100; below about 1050; below about 1000; below about 950;below about 900; below about 850; below about 800; below about 750;below about 700; below about 650; below about 600; below about 550;below about 500; below about 450; below about 400; below about 350;below about 300; below about 250; below about 200; and below about 100Daltons.

Exemplary ranges of molecular weights of the water-soluble, non-peptidicoligomer (excluding the linker) include: from about 100 to about 1400Daltons; from about 100 to about 1200 Daltons; from about 100 to about800 Daltons; from about 100 to about 500 Daltons; from about 100 toabout 400 Daltons; from about 200 to about 500 Daltons; from about 200to about 400 Daltons; from about 75 to 1000 Daltons; and from about 75to about 750 Daltons.

Preferably, the number of monomers in the water-soluble, non-peptidicoligomer falls within one or more of the following ranges: between about1 and about 30 (inclusive); between about 1 and about 25; between about1 and about 20; between about 1 and about 15; between about 1 and about12; between about 1 and about 10. In certain instances, the number ofmonomers in series in the oligomer (and the corresponding conjugate) isone of 1, 2, 3, 4, 5, 6, 7, or 8. In additional embodiments, theoligomer (and the corresponding conjugate) contains 9, 10, 11, 12, 13,14, 15, 16, 17, 18, 19, or 20 monomers in series. In yet furtherembodiments, the oligomer (and the corresponding conjugate) possesses21, 22, 23, 24, 25, 26, 27, 28, 29 or 30 monomers in series. Thus, forexample, when the water-soluble, non-peptidic polymer includesCH₃—(OCH₂CH₂)_(n)—, “n” is an integer that can be 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25,26, 27, 28, 29 or 30, and can fall within one or more of the followingranges: between about 1 and about 25; between about 1 and about 20;between about 1 and about 15; between about 1 and about 12; betweenabout 1 and about 10.

When the water-soluble, non-peptidic oligomer has 1, 2, 3, 4, 5, 6, 7,8, 9, or 10 monomers, these values correspond to a methoxy end-cappedoligo(ethylene oxide) having a molecular weights of about 75, 119, 163,207, 251, 295, 339, 383, 427, and 471 Daltons, respectively. When theoligomer has 11, 12, 13, 14, or 15 monomers, these values correspond tomethoxy end-capped oligo(ethylene oxide) having molecular weightscorresponding to about 515, 559, 603, 647, and 691 Daltons,respectively.

When the water-soluble, non-peptidic oligomer is attached to theanticholinergic agent (in contrast to the step-wise addition of one ormore monomers to effectively “grow” the oligomer onto theanticholinergic agent), it is preferred that the composition containingan activated form of the water-soluble, non-peptidic oligomer bemonodispersed. In those instances, however, where a bimodal compositionis employed, the composition will possess a bimodal distributioncentering around any two of the above numbers of monomers. Ideally, thepolydispersity index of each peak in the bimodal distribution, Mw/Mn, is1.01 or less, and even more preferably, is 1.001 or less, and even morepreferably is 1.0005 or less. Most preferably, each peak possesses aMW/Mn value of 1.0000. For instance, a bimodal oligomer may have any oneof the following exemplary combinations of monomer subunits: 1-2, 1-3,1-4, 1-5, 1-6, 1-7, 1-8, 1-9, 1-10, and so forth; 2-3, 2-4, 2-5, 2-6,2-7, 2-8, 2-9, 2-10, and so forth; 3-4, 3-5, 3-6, 3-7, 3-8, 3-9, 3-10,and so forth; 4-5, 4-6, 4-7, 4-8, 4-9, 4-10, and so forth; 5-6, 5-7,5-8, 5-9, 5-10, and so forth; 6-7, 6-8, 6-9, 6-10, and so forth; 7-8,7-9, 7-10, and so forth; and 8-9, 8-10, and so forth.

In some instances, the composition containing an activated form of thewater-soluble, non-peptidic oligomer will be trimodal or eventetramodal, possessing a range of monomers units as previouslydescribed. Oligomer compositions possessing a well-defined mixture ofoligomers (i.e., being bimodal, trimodal, tetramodal, and so forth) canbe prepared by mixing purified monodisperse oligomers to obtain adesired profile of oligomers (a mixture of two oligomers differing onlyin the number of monomers is bimodal; a mixture of three oligomersdiffering only in the number of monomers is trimodal; a mixture of fouroligomers differing only in the number of monomers is tetramodal), oralternatively, can be obtained from column chromatography of apolydisperse oligomer by recovering the “center cut”, to obtain amixture of oligomers in a desired and defined molecular weight range.

It is preferred that the water-soluble, non-peptidic oligomer isobtained from a composition that is preferably unimolecular ormonodisperse. That is, the oligomers in the composition possess the samediscrete molecular weight value rather than a distribution of molecularweights. Some monodisperse oligomers can be purchased from commercialsources such as those available from Sigma-Aldrich, or alternatively,can be prepared directly from commercially available starting materialssuch as Sigma-Aldrich. Water-soluble, non-peptidic oligomers can beprepared as described in Chen Y., Baker, G. L., J. Org. Chem., 6870-6873(1999), WO 02/098949, and U.S. Patent Application Publication2005/0136031.

When present, the spacer moiety (through which the water-soluble,non-peptidic polymer is attached to the anticholinergic agent) may be asingle bond, a single atom, such as an oxygen atom or a sulfur atom, twoatoms, or a number of atoms. A spacer moiety is typically but is notnecessarily linear in nature. The spacer moiety, “X” is hydrolyticallystable, and is preferably also enzymatically stable. Preferably, thespacer moiety “X” is one having a chain length of less than about 12atoms, and preferably less than about 10 atoms, and even more preferablyless than about 8 atoms and even more preferably less than about 5atoms, whereby length is meant the number of atoms in a single chain,not counting substituents. For instance, a urea linkage such as this,R_(oligomer)—NH—(C═O)—NH—R′_(drug), is considered to have a chain lengthof 3 atoms (—NH—C(O)—NH—). In selected embodiments, the linkage does notcomprise further spacer groups.

In some instances, the spacer moiety “X” comprises an ether, amide,urethane, amine, thioether, urea, or a carbon-carbon bond. Functionalgroups such as those discussed below, and illustrated in the examples,are typically used for forming the linkages. The spacer moiety may lesspreferably also comprise (or be adjacent to or flanked by) spacergroups, as described further below. Spacers are most useful in instanceswhere the bioactivity of the conjugate is significantly reduced due tothe positioning of the oligomer on the parent drug.

More specifically, in selected embodiments, a spacer moiety, X, may beany of the following: “-” (i.e., a covalent bond, that may be stable ordegradable, between the residue of the small molecule anticholinergicagent and the water-soluble, non-peptidic oligomer), —O—, —NH—, —S—,—C(O)—, C(O)—NH, NH—C(O)—NH, O—C(O)—NH, —C(S)—, —CH₂—, —CH₂—CH₂—,—CH₂—CH₂—CH₂—, —CH₂—CH₂—CH₂—CH₂—, —O—CH₂—, —CH₂—O—, —O—CH₂—CH₂—,—CH₂—O—CH₂—, —CH₂—CH₂—O—, —O—CH₂—CH₂—CH₂—, —CH₂—O—CH₂—CH₂—,—CH₂—CH₂—O—CH₂—, —CH₂—CH₂—CH₂—O—, —O—CH₂—CH₂—CH₂—CH₂—,—CH₂—O—CH₂—CH₂—CH₂—, —CH₂—CH₂—O—CH₂—CH₂—, —CH₂—CH₂—CH₂—O—CH₂—,—CH₂—CH₂—CH₂—CH₂—O—, —C(O)—NH—CH₂—, —C(O)—NH—CH₂—CH₂—,—CH₂—C(O)—NH—CH₂—, —CH₂—CH₂—C(O)—NH—, —C(O)—NH—CH₂—CH₂—CH₂—,—CH₂—C(O)—NH—CH₂—CH₂—, —CH₂—CH₂—C(O)—NH—CH₂—, —CH₂—CH₂—CH₂—C(O)—NH—,—C(O)—NH—CH₂—CH₂—CH₂—CH₂—, —CH₂—C(O)—NH—CH₂—CH₂—CH₂—,—CH₂—CH₂—C(O)—NH—CH₂—CH₂—, —CH₂—CH₂—CH₂—C(O)—NH—CH₂—,—CH₂—CH₂—CH₂—C(O)—NH—CH₂—CH₂—, —CH₂—CH₂—CH₂—CH₂—C(O)—NH—, —NH—C(O)—CH₂—,—CH₂—NH—C(O)—CH₂—, —CH₂—CH₂—NH—C(O)—CH₂—, —NH—C(O)—CH₂—CH₂—,—CH₂—NH—C(O)—CH₂—CH₂, —CH₂—CH₂—NH—C(O)—CH₂—CH₂, —C(O)—NH—CH₂—,—C(O)—NH—CH₂—CH₂—, —O—C(O)—NH—CH₂—, —O—C(O)—NH—CH₂—CH₂—, —NH—CH₂—,—NH—CH₂—CH₂—, —CH₂—NH—CH₂—, —CH₂—CH₂—NH—CH₂—, —C(O)—CH₂—,—C(O)—CH₂—CH₂—, —CH₂—C(O)—CH₂—, —CH₂—CH₂—C(O)—CH₂—,—CH₂—CH₂—C(O)—CH₂—CH₂—, —CH₂—CH₂—C(O)—,—CH₂—CH₂—CH₂—C(O)—NH—CH₂—CH₂—NH—, —CH₂—CH₂—CH₂—C(O)—NH—CH₂—CH₂—NH—C(O)—,—CH₂—CH₂—CH₂—C(O)—NH—CH₂—CH₂—NH—C(O)—CH₂—, bivalent cycloalkyl group,—N(R⁶)—, R⁶ is H or an organic radical selected from the groupconsisting of alkyl, substituted alkyl, alkenyl, substituted alkenyl,alkynyl, substituted alkynyl, aryl and substituted aryl.

For purposes of the present invention, however, a series of atoms is notconsidered as a spacer moiety when the series of atoms is immediatelyadjacent to an oligomer segment, and the series of atoms is but anothermonomer such that the proposed linkage would represent a mere extensionof the oligomer chain.

The spacer moeity “X” between the water-soluble, non-peptidic oligomerand the small molecule is typically formed by reaction of a functionalgroup on a terminus of the oligomer (or one or more monomers when it isdesired to “grow” the oligomer onto the anticholinergic agent) with acorresponding functional group within the anticholinergic agent.Illustrative reactions are described briefly below. For example, anamino group on an oligomer may be reacted with a carboxylic acid or anactivated carboxylic acid derivative on the small molecule, or viceversa, to produce an amide linkage. Alternatively, reaction of an amineon an oligomer with an activated carbonate (e.g. succinimidyl orbenzotriazyl carbonate) on the drug, or vice versa, forms a carbamatelinkage. Reaction of an amine on an oligomer with an isocyanate(R—N═C═O) on a drug, or vice versa, forms a urea linkage(R—NH—(C═O)—NH—R′). Further, reaction of an alcohol (alkoxide) group onan oligomer with an alkyl halide, or halide group within a drug, or viceversa, forms an ether linkage. In yet another coupling approach, a smallmolecule having an aldehyde function is coupled to an oligomer aminogroup by reductive amination, resulting in formation of a secondaryamine linkage between the oligomer and the small molecule.

A particularly preferred water-soluble, non-peptidic oligomer is anoligomer bearing an aldehyde functional group. In this regard, theoligomer will have the following structure:CH₃O—(CH₂—CH₂—O)_(n)—(CH₂)_(p)—C(O)H, wherein (n) is one of 1, 2, 3, 4,5, 6, 7, 8, 9 and 10 and (p) is one of 1, 2, 3, 4, 5, 6 and 7. Preferred(n) values include 3, 5 and 7 and preferred (p) values 2, 3 and 4. Inaddition, the carbon atom alpha to the —C(O)H moiety can optionally besubstituted with alkyl.

Typically, the terminus of the water-soluble, non-peptidic oligomer notbearing a functional group is capped to render it unreactive. When theoligomer does include a further functional group at a terminus otherthan that intended for formation of a conjugate, that group is eitherselected such that it is unreactive under the conditions of formation ofthe spacer moiety “X,” or it is protected during the formation of thespacer moiety “X.”

As stated above, the water-soluble, non-peptidic oligomer includes atleast one functional group prior to conjugation. The functional grouptypically comprises an electrophilic or nucleophilic group for covalentattachment to a small molecule, depending upon the reactive groupcontained within or introduced into the small molecule. Examples ofnucleophilic groups that may be present in either the oligomer or thesmall molecule include hydroxyl, amine, hydrazine (—NHNH₂), hydrazide(—C(O)NHNH₂), and thiol. Preferred nucleophiles include amine,hydrazine, hydrazide, and thiol, particularly amine. Most small moleculedrugs for covalent attachment to an oligomer will possess a freehydroxyl, amino, thio, aldehyde, ketone, or carboxyl group.

Examples of electrophilic functional groups that may be present ineither the oligomer or the small molecule include carboxylic acid,carboxylic ester, particularly imide esters, orthoester, carbonate,isocyanate, isothiocyanate, aldehyde, ketone, thione, alkenyl, acrylate,methacrylate, acrylamide, sulfone, maleimide, disulfide, iodo, epoxy,sulfonate, thiosulfonate, silane, alkoxysilane, and halosilane. Morespecific examples of these groups include succinimidyl ester orcarbonate, imidazoyl ester or carbonate, benzotriazole ester orcarbonate, vinyl sulfone, chloroethylsulfone, vinylpyridine, pyridyldisulfide, iodoacetamide, glyoxal, dione, mesylate, tosylate, andtresylate (2,2,2-trifluoroethanesulfonate).

Also included are sulfur analogs of several of these groups, such asthione, thione hydrate, thioketal, is 2-thiazolidine thione, etc., aswell as hydrates or protected derivatives of any of the above moieties(e.g. aldehyde hydrate, hemiacetal, acetal, ketone hydrate, hemiketal,ketal, thioketal, thioacetal).

An “activated derivative” of a carboxylic acid refers to a carboxylicacid derivative which reacts readily with nucleophiles, generally muchmore readily than the underivatized carboxylic acid. Activatedcarboxylic acids include, for example, acid halides (such as acidchlorides), anhydrides, carbonates, and esters. Such esters includeimide esters, of the general form —(CO)O—N[(CO)—]₂; for example,N-hydroxysuccinimidyl (NHS) esters or N-hydroxyphthalimidyl esters. Alsopreferred are imidazolyl esters and benzotriazole esters. Particularlypreferred are activated propionic acid or butanoic acid esters, asdescribed in co-owned U.S. Pat. No. 5,672,662. These include groups ofthe form —(CH₂)₂₋₃C(═O)O-Q, where Q is preferably selected fromN-succinimide, N-sulfosuccinimide, N-phthalimide, N-glutarimide,N-tetrahydrophthalimide, N-norbornene-2,3-dicarboximide, benzotriazole,7-azabenzotriazole, and imidazole.

Other preferred electrophilic groups include succinimidyl carbonate,maleimide, benzotriazole carbonate, glycidyl ether, imidazoyl carbonate,p-nitrophenyl carbonate, acrylate, tresylate, aldehyde, and orthopyridyldisulfide.

These electrophilic groups are subject to reaction with nucleophiles,e.g. hydroxy, thio, or amino groups, to produce various bond types.Preferred for the present invention are reactions which favor formationof a hydrolytically stable linkage. For example, carboxylic acids andactivated derivatives thereof, which include orthoesters, succinimidylesters, imidazolyl esters, and benzotriazole esters, react with theabove types of nucleophiles to form esters, thioesters, and amides,respectively, of which amides are the most hydrolytically stable.Carbonates, including succinimidyl, imidazolyl, and benzotriazolecarbonates, react with amino groups to form carbamates. Isocyanates(R—N═C═O) react with hydroxyl or amino groups to form, respectively,carbamate (RNH—C(O)—OR′) or urea (RNH—C(O)—NHR′) linkages. Aldehydes,ketones, glyoxals, diones and their hydrates or alcohol adducts (i.e.aldehyde hydrate, hemiacetal, acetal, ketone hydrate, hemiketal, andketal) are preferably reacted with amines, followed by reduction of theresulting imine, if desired, to provide an amine linkage (reductiveamination).

Several of the electrophilic functional groups include electrophilicdouble bonds to which nucleophilic groups, such as thiols, can be added,to form, for example, thioether bonds. These groups include maleimides,vinyl sulfones, vinyl pyridine, acrylates, methacrylates, andacrylamides. Other groups comprise leaving groups that can be displacedby a nucleophile; these include chloroethyl sulfone, pyridyl disulfides(which include a cleavable S—S bond), iodoacetamide, mesylate, tosylate,thiosulfonate, and tresylate. Epoxides react by ring opening by anucleophile, to form, for example, an ether or amine bond. Reactionsinvolving complementary reactive groups such as those noted above on theoligomer and the small molecule are utilized to prepare the conjugatesof the invention.

In some instances the anticholinergic agent may not have a functionalgroup suited for conjugation. In this instance, it is possible to modifythe “original” anticholinergic agent so that it does have the desiredanticholinergic agent. For example, if the anticholinergic agent has anamide group, but an amine group is desired, it is possible to modify theamide group to an amine group by way of a Hofmann rearrangement, Curtiusrearrangement (once the amide is converted to an azide) or Lossenrearrangement (once the amide is concerted to hydroxamide followed bytreatment with tolyene-2-sulfonyl chloride/base).

It is possible to prepare a conjugate of small molecule anticholinergicagent bearing a carboxyl group wherein the carboxyl group-bearing smallmolecule anticholinergic agent is coupled to an amino-terminatedoligomeric ethylene glycol, to provide a conjugate having an amide groupcovalently linking the small molecule anticholinergic agent to theoligomer. This can be performed, for example, by combining the carboxylgroup-bearing small molecule anticholinergic agent with theamino-terminated oligomeric ethylene glycol in the presence of acoupling reagent, (such as dicyclohexylcarbodiimide or “DCC”) in ananhydrous organic solvent.

Further, it is possible to prepare a conjugate of a small moleculeanticholinergic agent bearing a hydroxyl group wherein the hydroxylgroup-bearing small molecule anticholinergic agent is coupled to anoligomeric ethylene glycol halide to result in an ether (—O—) linkedsmall molecule conjugate. This can be performed, for example, by usingsodium hydride to deprotonate the hydroxyl group followed by reactionwith a halide-terminated oligomeric ethylene glycol.

In another example, it is possible to prepare a conjugate of a smallmolecule anticholinergic agent bearing a ketone group by first reducingthe ketone group to form the corresponding hydroxyl group. Thereafter,the small molecule anticholinergic agent now bearing a hydroxyl groupcan be coupled as described herein.

In still another instance, it is possible to prepare a conjugate of asmall molecule anticholinergic agent bearing an amine group. In oneapproach, the amine group-bearing small molecule anticholinergic agentand an aldehyde-bearing oligomer are dissolved in a suitable bufferafter which a suitable reducing agent (e.g., NaCNBH₃) is added.Following reduction, the result is an amine linkage formed between theamine group of the amine group-containing small molecule anticholinergicagent and the carbonyl carbon of the aldehyde-bearing oligomer.

In another approach for preparing a conjugate of a small moleculeanticholinergic agent bearing an amine group, a carboxylic acid-bearingoligomer and the amine group-bearing small molecule anticholinergicagent are combined, typically in the presence of a coupling reagent(e.g., DCC). The result is an amide linkage formed between the aminegroup of the amine group-containing small molecule anticholinergic agentand the carbonyl of the carboxylic acid-bearing oligomer.

Exemplary conjugates of the anticholinergic agents of Formula I includethose having the following structure:

wherein each of R¹, R², R³, L², R⁵, and the optional quaternary amine isas previously defined with respect to Formula I, and X is a spacermoiety, and POLY is a water-soluble, non-peptidic oligomer. With respectto Formula I-Ca, preferred “POLY” include (CH₂CH₂O)_(n)CH₃, wherein (n)is 1 to 20. Also with respect to Formula I-Ca, a preferred X is a stablecovalent linkage (i.e., “-”)

Further exemplary conjugates of the anticholinergic agents include thosehaving the following structure:

wherein each of R¹, R², R³, L, R⁵, and the optional quaternary amine isas previously defined with respect to Formula I, and X is a spacermoiety, and POLY is a water-soluble, non-peptidic oligomer. With respectto Formula I-Cb, preferred “POLY” include (CH₂CH₂O)_(n)CH₃, wherein (n)is 1 to 20. Also with respect to Formula I-Cb, a preferred X is a stablecovalent linkage (i.e., “-”)

The conjugates of the invention can exhibit a reduced blood-brainbarrier crossing rate. Moreover, the conjugates maintain at least about5%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, or more of the bioactivity of theunmodified parent small molecule drug.

The selection of an optimally sized oligomer can be determined asfollows.

First, an oligomer obtained from a monodisperse or bimodal water solubleoligomer is conjugated to the small molecule drug. Preferably, the drugis orally bioavailable, and on its own, exhibits a blood-brain barriercrossing rate. Next, the ability of the conjugate to cross theblood-brain barrier is determined using an appropriate model andcompared to that of the unmodified parent drug. If the results arefavorable, that is to say, if, for example, the rate of crossing issignificantly reduced, then the bioactivity of conjugate is furtherevaluated. In one or more embodiments, the drug in conjugated form canbe bioactive, and preferably, maintains a significant degree ofbioactivity relative to the parent drug, i.e., greater than about 30% ofthe bioactivity of the parent drug, or even more preferably, greaterthan about 50% of the bioactivity of the parent drug.

Then, the above steps are repeated using oligomers of the same monomertype but having a different number of subunits.

For each conjugate whose ability to cross the blood-brain barrier isreduced in comparison to the non-conjugated small molecule drug, itsoral bioavailability is then assessed. Based upon these results, that isto say, based upon the sequential addition of increasing numbers ofdiscrete monomers to a given small molecule at a given position orlocation within the small molecule, it is possible to determine the sizeof the oligomer most effective in providing a conjugate having anoptimal balance between reduction in biological membrane crossing, oralbioavailability, and bioactivity. The small size of the oligomers makessuch screenings feasible, and allows one to effectively tailor theproperties of the resulting conjugate. By making small, incrementalchanges in oligomer size, and utilizing an experimental design approach,one can effectively identify a conjugate having a favorable balance ofreduction in biological membrane crossing rate, bioactivity, and oralbioavailability. In some instances, attachment of an oligomer asdescribed herein is effective to actually increase oral bioavailabilityof the drug.

For example, one of ordinary skill in the art, using routineexperimentation, can determine a best suited molecular size and linkagefor improving oral bioavailability by first preparing a series ofoligomers with different weights and functional groups and thenobtaining the necessary clearance profiles by administering theconjugates to a patient and taking periodic blood and/or urine sampling.Once a series of clearance profiles have been obtained for each testedconjugate, a suitable conjugate can be identified.

Animal models (e.g., rodents and dogs) can also be used to study oraldrug transport. In addition, non-in vivo methods include rodent evertedgut excised tissue and Caco-2 cell monolayer tissue-culture models. Inaddition, the Experimental provides additional approaches to test oraldrug transport. These models are useful in predicting oral drugbioavailability.

To determine whether the anticholinergic agent of Formula I or theconjugate of an anticholinergic agent and a water-soluble, non-peptidicpolymer has binding activity to muscarinic receptors and/or hasantimuscarinic receptor antagonist activity to, it is possible to testsuch a compound. For example, the muscarinic receptor affinity can bedetermined by an in vitro receptor binding assay which utilizes a cellmembrane preparation from the Chinese hamster ovary cells expressing therecombinant human muscarinic receptors. Briefly, in a radioligandbinding study, the inhibitory activity of a compound can be determinedusing a modification of the method described in Hegde et al. (1997) Br.J. Pharmacol., 120:1409-1418. In this approach, cell membranes fromChinese hamster ovary cells expressing the recombinant human muscarinicreceptors can be used. The assays are conducted with the radioligand[³H]N-methyl scopolamine (0.4 nM, specific activity 84 Ci/mmol⁻¹) in afinal volume of 0.25 mL Tris-Krebs buffer. Non-specific binding isdefined with 1 μM atropine.

In another test, it is possible to determine the inhibition ofvolume-induced contractions in rats. Briefly, the muscarinic receptorinhibitory activity in vivo can be determined in rats using amodification of the method described in Hegde et al. (1996) Proceedingsof the 26th Annual Meeting of the International Continence Society(August 27th 30th), Abstract 126. Female Sprague-Dawley rats can beanesthetized with urethane and instrumented for intravenousadministration of drugs and, in some cases, measurement of arterialpressure, heart rate and intra-bladder pressure. The effect of testcompounds on volume-induced bladder contractions can be determined inseparate groups of animals. Volume-induced reflex bladder contractionscan be induced by filling the bladder with saline. The test compound canbe administered intravenously in a cumulative manner at 10-minuteintervals. Atropine (0.3 mg/kg, iv) can be administered at the end ofthe study as a positive control.

The present invention also includes pharmaceutical preparationscomprising a conjugate as provided herein in combination with apharmaceutical excipient. Generally, the conjugate itself will be in asolid form (e.g., a precipitate), which can be combined with a suitablepharmaceutical excipient that can be in either solid or liquid form.

Exemplary excipients include, without limitation, those selected fromthe group consisting of carbohydrates, inorganic salts, antimicrobialagents, antioxidants, surfactants, buffers, acids, bases, andcombinations thereof.

A carbohydrate such as a sugar, a derivatized sugar such as an alditol,aldonic acid, an esterified sugar, and/or a sugar polymer may be presentas an excipient. Specific carbohydrate excipients include, for example:monosaccharides, such as fructose, maltose, galactose, glucose,D-mannose, sorbose, and the like; disaccharides, such as lactose,sucrose, trehalose, cellobiose, and the like; polysaccharides, such asraffinose, melezitose, maltodextrins, dextrans, starches, and the like;and alditols, such as mannitol, xylitol, maltitol, lactitol, xylitol,sorbitol (glucitol), pyranosyl sorbitol, myoinositol, and the like.

The excipient can also include an inorganic salt or buffer such ascitric acid, sodium chloride, potassium chloride, sodium sulfate,potassium nitrate, sodium phosphate monobasic, sodium phosphate dibasic,and combinations thereof.

The preparation may also include an antimicrobial agent for preventingor deterring microbial growth. Nonlimiting examples of antimicrobialagents suitable for the present invention include benzalkonium chloride,benzethonium chloride, benzyl alcohol, cetylpyridinium chloride,chlorobutanol, phenol, phenylethyl alcohol, phenylmercuric nitrate,thimersol, and combinations thereof.

An antioxidant can be present in the preparation as well. Antioxidantsare used to prevent oxidation, thereby preventing the deterioration ofthe conjugate or other components of the preparation. Suitableantioxidants for use in the present invention include, for example,ascorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene,hypophosphorous acid, monothioglycerol, propyl gallate, sodiumbisulfate, sodium formaldehyde sulfoxylate, sodium metabisulfite, andcombinations thereof.

A surfactant may be present as an excipient. Exemplary surfactantsinclude: polysorbates, such as “Tween 20” and “Tween 80,” and pluronicssuch as F68 and F88 (both of which are available from BASF, Mount Olive,N.J.); sorbitan esters; lipids, such as phospholipids such as lecithinand other phosphatidylcholines, phosphatidylethanolamines (althoughpreferably not in liposomal form), fatty acids and fatty esters;steroids, such as cholesterol; and chelating agents, such as EDTA, zincand other such suitable cations.

Pharmaceutically acceptable acids or bases may be present as anexcipient in the preparation. Nonlimiting examples of acids that can beused include those acids selected from the group consisting ofhydrochloric acid, acetic acid, phosphoric acid, citric acid, malicacid, lactic acid, formic acid, trichloroacetic acid, nitric acid,perchloric acid, phosphoric acid, sulfuric acid, fumaric acid, andcombinations thereof. Examples of suitable bases include, withoutlimitation, bases selected from the group consisting of sodiumhydroxide, sodium acetate, ammonium hydroxide, potassium hydroxide,ammonium acetate, potassium acetate, sodium phosphate, potassiumphosphate, sodium citrate, sodium formate, sodium sulfate, potassiumsulfate, potassium fumerate, and combinations thereof.

The amount of the conjugate in the composition will vary depending on anumber of factors, but will optimally be a therapeutically effectivedose when the composition is stored in a unit dose container. Atherapeutically effective dose can be determined experimentally byrepeated administration of increasing amounts of the conjugate in orderto determine which amount produces a clinically desired endpoint.

The amount of any individual excipient in the composition will varydepending on the activity of the excipient and particular needs of thecomposition. Typically, the optimal amount of any individual excipientis determined through routine experimentation, i.e., by preparingcompositions containing varying amounts of the excipient (ranging fromlow to high), examining the stability and other parameters, and thendetermining the range at which optimal performance is attained with nosignificant adverse effects.

Generally, however, the excipient will be present in the composition inan amount of about 1% to about 99% by weight, preferably from about5%-98% by weight, more preferably from about 15-95% by weight of theexcipient, with concentrations less than 30% by weight most preferred.

These foregoing pharmaceutical excipients along with other excipientsand general teaching regarding pharmaceutical preparations are describedin “Remington: The Science & Practice of Pharmacy”, 19^(th) ed.,Williams & Williams, (1995), the “Physician's Desk Reference”, 52^(nd)ed., Medical Economics, Montvale, N.J. (1998), and Kibbe, A. H.,Handbook of Pharmaceutical Excipients, 3^(rd) Edition, AmericanPharmaceutical Association, Washington, D.C., 2000.

The pharmaceutical compositions can take any number of forms and theinvention is not limited in this regard. Exemplary preparations are mostpreferably in a form suitable for oral administration such as a tablet,caplet, capsule, gel cap, troche, dispersion, suspension, solution,elixir, syrup, lozenge, transdermal patch, spray, suppository, andpowder.

Oral dosage forms are preferred for those conjugates that are orallyactive, and include tablets, caplets, capsules, gel caps, suspensions,solutions, elixirs, and syrups, and can also comprise a plurality ofgranules, beads, powders or pellets that are optionally encapsulated.Such dosage forms are prepared using conventional methods known to thosein the field of pharmaceutical formulation and described in thepertinent texts.

Tablets and caplets, for example, can be manufactured using standardtablet processing procedures and equipment. Direct compression andgranulation techniques are preferred when preparing tablets or capletscontaining the conjugates described herein. In addition to theconjugate, the tablets and caplets will generally contain inactive,pharmaceutically acceptable carrier materials such as binders,lubricants, disintegrants, fillers, stabilizers, surfactants, coloringagents, and the like. Binders are used to impart cohesive qualities to atablet, and thus ensure that the tablet remains intact. Suitable bindermaterials include, but are not limited to, starch (including corn starchand pregelatinized starch), gelatin, sugars (including sucrose, glucose,dextrose and lactose), polyethylene glycol, waxes, and natural andsynthetic gums, e.g., acacia sodium alginate, polyvinylpyrrolidone,cellulosic polymers (including hydroxypropyl cellulose, hydroxypropylmethylcellulose, methyl cellulose, microcrystalline cellulose, ethylcellulose, hydroxyethyl cellulose, and the like), and Veegum. Lubricantsare used to facilitate tablet manufacture, promoting powder flow andpreventing particle capping (i.e., particle breakage) when pressure isrelieved. Useful lubricants are magnesium stearate, calcium stearate,and stearic acid. Disintegrants are used to facilitate disintegration ofthe tablet, and are generally starches, clays, celluloses, algins, gums,or crosslinked polymers. Fillers include, for example, materials such assilicon dioxide, titanium dioxide, alumina, talc, kaolin, powderedcellulose, and microcrystalline cellulose, as well as soluble materialssuch as mannitol, urea, sucrose, lactose, dextrose, sodium chloride, andsorbitol. Stabilizers, as well known in the art, are used to inhibit orretard drug decomposition reactions that include, by way of example,oxidative reactions.

Capsules are also preferred oral dosage forms, in which case theconjugate-containing composition can be encapsulated in the form of aliquid or gel (e.g., in the case of a gel cap) or solid (includingparticulates such as granules, beads, powders or pellets). Suitablecapsules include hard and soft capsules, and are generally made ofgelatin, starch, or a cellulosic material. Two-piece hard gelatincapsules are preferably sealed, such as with gelatin bands or the like.

Included are parenteral formulations in the substantially dry form(typically as a lyophilizate or precipitate, which can be in the form ofa powder cake), as well as formulations prepared for injection, whichare typically liquid and requires the step of reconstituting the dryform of parenteral formulation. Examples of suitable diluents forreconstituting solid compositions prior to injection includebacteriostatic water for injection, dextrose 5% in water,phosphate-buffered saline, Ringer's solution, saline, sterile water,deionized water, and combinations thereof.

In some cases, compositions intended for parenteral administration cantake the form of nonaqueous solutions, suspensions, or emulsions, eachtypically being sterile. Examples of nonaqueous solvents or vehicles arepropylene glycol, polyethylene glycol, vegetable oils, such as olive oiland corn oil, gelatin, and injectable organic esters such as ethyloleate.

The parenteral formulations described herein can also contain adjuvantssuch as preserving, wetting, emulsifying, and dispersing agents. Theformulations are rendered sterile by incorporation of a sterilizingagent, filtration through a bacteria-retaining filter, irradiation, orheat.

The conjugate can also be administered through the skin usingconventional transdermal patch or other transdermal delivery system,wherein the conjugate is contained within a laminated structure thatserves as a drug delivery device to be affixed to the skin. In such astructure, the conjugate is contained in a layer, or “reservoir,”underlying an upper backing layer. The laminated structure can contain asingle reservoir, or it can contain multiple reservoirs.

The conjugate can also be formulated into a suppository for rectaladministration. With respect to suppositories, the conjugate is mixedwith a suppository base material which is (e.g., an excipient thatremains solid at room temperature but softens, melts or dissolves atbody temperature) such as coca butter (theobroma oil), polyethyleneglycols, glycerinated gelatin, fatty acids, and combinations thereof.Suppositories can be prepared by, for example, performing the followingsteps (not necessarily in the order presented): melting the suppositorybase material to form a melt; incorporating the conjugate (either beforeor after melting of the suppository base material); pouring the meltinto a mold; cooling the melt (e.g., placing the melt-containing mold ina room temperature environment) to thereby form suppositories; andremoving the suppositories from the mold.

The invention also provides a method for administering a conjugate asprovided herein to a patient suffering from a condition that isresponsive to treatment with the conjugate. The method comprisesadministering, generally orally, a therapeutically effective amount ofthe conjugate (preferably provided as part of a pharmaceuticalpreparation). Other modes of administration are also contemplated, suchas pulmonary, nasal, buccal, rectal, sublingual, transdermal, andparenteral. As used herein, the term “parenteral” includes subcutaneous,intravenous, intra-arterial, intraperitoneal, intracardiac, intrathecal,and intramuscular injection, as well as infusion injections.

In instances where parenteral administration is utilized, it may benecessary to employ somewhat bigger oligomers than those describedpreviously, with molecular weights ranging from about 500 to 30K Daltons(e.g., having molecular weights of about 500, 1000, 2000, 2500, 3000,5000, 7500, 10000, 15000, 20000, 25000, 30000 or even more).

The method of administering may be used to treat any condition that canbe remedied or prevented by administration of the particular conjugate.Those of ordinary skill in the art appreciate which conditions aspecific conjugate can effectively treat. The actual dose to beadministered will vary depend upon the age, weight, and generalcondition of the subject as well as the severity of the condition beingtreated, the judgment of the health care professional, and conjugatebeing administered. Therapeutically effective amounts are known to thoseskilled in the art and/or are described in the pertinent reference textsand literature. Generally, a therapeutically effective amount will rangefrom about 0.001 mg to 1000 mg, preferably in doses from 0.01 mg/day to750 mg/day, and more preferably in doses from 0.10 mg/day to 500 mg/day.

The unit dosage of any given conjugate (again, preferably provided aspart of a pharmaceutical preparation) can be administered in a varietyof dosing schedules depending on the judgment of the clinician, needs ofthe patient, and so forth. The specific dosing schedule will be known bythose of ordinary skill in the art or can be determined experimentallyusing routine methods. Exemplary dosing schedules include, withoutlimitation, administration five times a day, four times a day, threetimes a day, twice daily, once daily, three times weekly, twice weekly,once weekly, twice monthly, once monthly, and any combination thereof.Once the clinical endpoint has been achieved, dosing of the compositionis halted.

All articles, books, patents, patent publications and other publicationsreferenced herein are incorporated by reference in their entireties. Inthe event of an inconsistency between the teachings of thisspecification and the art incorporated by reference, the meaning of theteachings in this specification shall prevail.

Experimental

It is to be understood that while the invention has been described inconjunction with certain preferred and specific embodiments, theforegoing description as well as the examples that follow are intendedto illustrate and not limit the scope of the invention. Other aspects,advantages and modifications within the scope of the invention will beapparent to those skilled in the art to which the invention pertains

All chemical reagents referred to in the appended examples arecommercially available unless otherwise indicated. The preparation ofPEG-mers is described in, for example, U.S. Patent ApplicationPublication No. 2005/0136031.

All ¹H NMR (nuclear magnetic resonance) data was generated by a NMRspectrometer manufactured by Bruker (MHz≧300).

Synthesis of PEG-Oxybutynin

PEG-Oxybutynin was prepared. Schematically, the approach followed forthis example is shown below.

Synthesis of 4-(tetrahydro-pyran-2-yloxy)-but-2-yn-1-ol (2)

3,4-Dihydro-2H-pyron (18.3 mL, 0.196 mol) in dichloromethane (30 mL) wasadded dropwise over 30 minutes to a stirred solution of2-butyne-1,4-di-ol (16.832 g, 0.194 mol) and p-TsOH (2.236 g, 11.58mmol) in DCM (250 mL) at 0° C. After addition, the mixture was stirredat room temperature for 4 hours. Sodium bicarbonate (858 mg) was added.The mixture was stirred for another hour. Water (10 mL) was added,followed by addition of saturated aqueous potassium carbonate (150 mL).The organic phase was separated and washed with brine (200 mL), driedover anhydrous sodium sulfate, and concentrated under reduced pressure(temperature below 25° C.). The residue was separated by flash columnchromatography on silica gel using 5-25% EtOAc/hexane to afford 12.88 gof product (yield: 39%), along with 12.05 g of di-protected sideproduct. ¹H-NMR (CDCl₃): δ 4.78 (t, J=3.0-3.3 Hz, 1H), 4.37-4.21 (m,4H), 3.86-3.78 (m, 1H), 3.55-3.50 (m, 1H), 1.83-1.64 (m, 6H).

Synthesis of 4-(tetrahydro-pyran-2-yloxy)-but-2-ynyl mesylate (3) (x=Ms)

Methanesulfonyl chloride (1.0 mL, 12.80 mmol) was added dropwise to astirred solution of 4-(tetrahydro-pyran-2-yloxy)-but-2-yn-1-ol (1.9232g, 11.30 mmol) and TEA (2.5 mL, 17.85 mmol) in DCM (40 mL) at ° C. forfive minutes. And then the resulting mixture was stirred at roomtemperature for 5.5 hours. Water (20 mL) was added, followed by additionof saturated aqueous NaCl solution (70 mL). The organic phase wasseparated and washed again with brine (60 mL), dried over Na₂SO₄,concentrated. The residue was separated by flash column chromatographyon silica gel using 5-25% EtOAc/hexane to afford 1.542 g of product(yield 55%, oil), along with 400 mg ofDi-4-(tetrahydro-pyran-2-yloxy)-but-2-ynyl ether (yield 22%). ¹H-NMR(CDCl₃): δ 4.88 (t, J=1.8 Hz, 2H), 4.76 (t, J=3.0-3.3 Hz, 1H), 4.37-4.24(m, 2H), 180-3.76 (m, 1H), 3.54-3.50 (m, 1H), 3.11 (s, 3H), 1.78-1.51(m, 6H).

Synthesis of 4-(tetrahydro-pyran-2-yloxy)-but-2-ynyl iodide (3) (x=1)

To a stirred solution of triphenylphosphine (1.4154 g, 5.34 mmol) inanhydrous dichlormethane (20 mL) at room temperature under nitrogen wasadded imidazole (360 mg, 5.24 mmol), followed by iodide (1.2688 g, 4.95mmol). The mixture was stirred for three minutes, a solution of4-(tetrahydro-pyran-2-yloxy)-but-2-yn-1-ol (708.6 mg, 4.16 mmol) indichloromethane was added dropwise via spring. The resulting mixture wascontinued to be stirred for 1.5 hours. The mixture was filtered througha pad of Celite. And the solid was washed with dichloromethane. Thecombined organic filtration was concentrated under reduced pressure. Theresidue was separated with flash column chromatography on silica using0-20% EtOAc/hexane to afford 654 mg of product in 56% yield. ¹H-NMR(CDCl₃): δ 4.77 (t, J=3.0 Hz, 1H), 4.33-4.18 (m, 2H), 3.85-3.77 (m, 1H),3.70 (t, J=2.1 Hz, 2H), 3.56-3.49 (m, 1H), 1.85-1.62 (m, 6H).

Synthesis of mPEG₅-OMs (5) (n=5)

MSCl (2.5 mL, 32 mmol) was added dropwise to a stirred solution ofmPEG₅-OH (5.30 g, 21 mmol) and TEA (6 mL, 42.8 mmol) in dichloromethane(50 mL) at 0° C. After addition, the resulting solution was stirred atroom temperature for 22 hours. Water (10 n mL) was added to quench thereaction and some saturated NaCl solution (˜40 mL) was added. Theorganic solution was separated and washed with brine (2×45 mL), driedover Na₂SO₄, and concentrated. The residue was dried under high vacuumto afford the product as a oil in quantitative yield. ¹H-NMR (CDCl₃): δ4.38-4.35 (m, 2H), 3.76-3.73 (m, 2H), 3.66-3.60 (m, 14H), 3.55-3.51 (m,2H), 3.36 (s, 3H), 3.06 (s, 3H).

Other mPEG_(n)-OMs (n=3, 4, 6-20) was and/or can be synthesizedfollowing the same procedures from the corresponding mPEG_(n)-OH.

Synthesis of mPEG₄-NHEt (6) (n=4)

Ethylamine (70 wt % solution in water) (8 mL, 98.9 mmol) was added to astirred solution of mPEG₄-OMs (2.75 g, 9.6 mmol) and K₂CO₃ (6.72 g,48.16 mmol) in water (10 mL) at 0° C. Tetrabutylammonium bromide (268mg, 0.82 mmol) was added. The resulting mixture was stirred at roomtemperature for 67 hours. The mixture was extracted with dichloromethane(3×20 mL). The combined organic solution was washed with brine, driedover anhydrous Na₂SO₄, concentrated to afford the product (2.373 g,90.6% purity based on ¹H-NMR) in 95% yield. ¹H-NMR (CDCl₃): δ 3.64-3.51(m, 14H), 3.36 (s, 3H), 2.76 (t, J=5.1-5.4 Hz, 2H), 2.63 (q, J=7.2 H,2H), 1.09 (t, J=7.2 Hz, 3H).

Other mPEG_(n)-NHEt can be synthesized following the same proceduresfrom the corresponding mPEG_(n)-OMs.

Synthesis of ethyl-mPEG₃-4-(tetrahydropyran-2-yloxy)-but-2-ynyl]amine(7) (n=3)

A mixture of 4-(tetrahydro-pyran-2-yloxy)-but-2-ynyl iodide (153 mg,0.55 mmol), mPEG₃-NHEt (124 mg, 0.58 mmol, 90% pure) in THF (3 mL) inthe presence of sodium bicarbonate (131 mg, 1.56 mmol) was stirred for24.5 hours at room temperature. Water was added to quench the reaction.The mixture was concentrated under reduced pressure to remove theorganic solvent. The remaining aqueous solution was extracted withEtOAc. The organic extraction was washed with brine, dried over sodiumsulfate, concentrated. The residue was purified with flash columnchromatography on silica gel using 0-9% MeOH/dichloromethane to affordthe product (85 mg, 45% yield). ¹H-NMR (CDCl₃): δ 4.77 (t, J=3.0 Hz,1H), 4.30-4.16 (m, 2H), 3.83-3.75 (m, 1H), 3.63-3.45 (m, 13H), 3.33 (s,3H), 2.66 (t, J=6.0 Hz, 2H), 2.53 (q, J=7.2 Hz, 2H), 1.82-1.47 (m, 6H),1.01 (t, J=7.2 Hz, 3H).

Synthesis of Ethyl-mPEG₆-4-(tetrahydropyran-2-yloxy)-but-2-ynyl]amine(7) (n=6)

A mixture of 4-(tetrahydro-pyran-2-yloxy)-but-2-ynyl iodide (376 mg,1.34 mmol), mPEG₆-NHEt (528 mg, 1.52 mmol, 93% pure) in THF (5 mL) inthe presence of sodium bicarbonate (345 mg, 4.11 mmol) was stirred for25 hours at room temperature. Water was added to quench the reaction.The mixture was concentrated under reduced pressure to remove theorganic solvent. The remaining aqueous solution was mixed with saturatedaqueous potassium carbonate solution (10 mL), extracted with EtOAc (3×40mL). The combined organic solution was washed with brine, dried oversodium sulfate, concentrated. The residue was purified with flash columnchromatography on silica gel using 0-9% MeOH/dichloromethane to affordthe product (293 mg, 46% yield). ¹H-NMR (CDCl₃): δ 4.80 (t, J=3.0 Hz,1H), 4.33-4.20 (m, 2H), 3.86-3.78 (m, 1H), 3.64-3.48 (m, 25H), 3.36 (s,3H), 2.69 (t, J=6.0 Hz, 2H), 2.56 (q, J=7.2 Hz, 2H), 1.85-1.62 (m, 6H),1.04 (t, J=7.2 Hz, 3H).

Synthesis of Ethyl-mPEG₉-4-(tetrahydropyran-2-yloxy)-but-2-ynyl]amine(7) (n=9)

A mixture of 4-(tetrahydro-pyran-2-yloxy)-but-2-ynyl iodide (587 mg,2.10 mmol), mPEG₉-NHEt (1.143 g, 2.38 mmol, 95% pure) in THF (5 mL) inthe presence of sodium bicarbonate (642 mg, 7.64 mmol) was stirred for26 hours at room temperature. Water was added to quench the reaction.The mixture was concentrated under reduced pressure to remove theorganic solvent. The remaining aqueous solution was mixed with saturatedaqueous potassium carbonate solution (10 mL), extracted withdichloromethane (3×20 mL). The combined organic solution was washed withbrine, dried over sodium sulfate, concentrated. The residue was purifiedwith flash column chromatography on silica gel using 0-5%MeOH/dichloromethane to afford the product (683 mg, 54% yield). ¹H-NMR(CDCl₃): δ 4.80 (t, J=3.0 Hz, 1H), 4.32-4.21 (m, 2H), 3.83 (m, 1H),3.64-3.48 (m, 37H), 3.36 (s, 3H), 2.69 (t, J=6.0 Hz, 2H), 2.58 (q, J=7.2Hz, 2H), 1.85-1.62 (m, 6H), 1.04 (t, J=7.2 Hz, 3H).

Synthesis of 4-(mPEG₆ ethylamino)-but-2-yn-1-ol (8) (n=6)

Ethyl-mPEG₆-4-(tetrahydropyran-2-yloxy)-but-2-ynyl]amine (292 mg, 0.61mmol) was stirred in 1 N HCl ethyl ether (6 mL) at room temperature forone hour. The mixture appeared two layers. A small amount ofdichloromethane was added. The resulting homogenous solution was stirredat room temperature for 17 hours. 5% aqueous sodium bicarbonate solution(20 mL) was added to quench the reaction. The mixture was extracted withdichloromethane (2×20 mL). The combined organic solution was washed withbrine (2×30 mL), dried over sodium sulfate, concentrated. The residuewas purified by flash column chromatography on silica gel (Biotage, 0-5%methanol/dichloromethane and 5% methanol/dichloromethane) to afford 81mg of product in 34% yield. ¹H-NMR (500 MHz, CDCl₃): δ 4.23 (t, J=2.0Hz, 2H), 3.62-3.56 (m, 20H), 3.52-3.50 (m, 2H), 3.47 (t, J=2.0 Hz, 2H),3.34 (s, 3H), 2.70 (t, J=6.0 Hz, 2H and OH), 2.56 (q, J=7.0 Hz, 2H),1.03 (t, J=7.0 Hz, 3H).

Synthesis of Cyclohexyl-hydroxy-phenylacetic acid (11)

A 250 mL round-bottom flask was charged with anhydrous THF (120 mL) atroom temperature and then cooled to 0° C. with water/ice bath.Cyclohexylmagnesium chloride solution (2.0 M in ethyl ether) (56 mL, 112mmol) was added. A solution of ethyl benzoylformate (14.89 g, 79.41mmol) in THF (20 mL) was added dropwise over 30 minutes. More of THF (10mL) was added to wash the addition funnel. The resulting mixture wasstirred at 0° C. for 15 minutes, and then at room temperature for threehours. The reaction mixture was poured into saturated aqueous ammoniumchloride (150 mL). Water (15 mL) was added. The mixture was concentratedto remove the organic solvents. The remaining solution was extractedwith EtOAc (2×100 mL). The extraction was washed with brine, dried oversodium sulfate, concentrated to afford a slight green residue. Theresidue was purified with flash column chromatography on silica gelusing 0-8% EtOAc/hexane (20 CV, 40 M column, biotage) to afford 14.955 gof product in 72% yield. ¹H-NMR (400 MHz, CDCl₃).

Synthesis of 2-Cyclohexyl-2-Phenylglycolic Acid (12)

To a solution of cyclohexyl-hydroxy-phenylacetic acid (1.04 g, 3.96mmol) in methanol (20 mL) was added a 1 N NaOH (8 mL). The reactionmixture was allowed to warm to 80° C. and stirred for 3.5 hours. Aftercooling to room temperature, the mixture was extracted with ethyl ether.The combined organic solution was washed with brine, dried over sodiumsulfate, and concentrated in vacuo to give crude product as a whitesolid. The solid was recrystallized with hexane and dichloromethane toafford 900 mg of 2-cyclohexyl-2-phenylglycolic acid in 97% yield. ¹H-NMR(CDCl₃).

Synthesis of mPEG₆-Oxybutynin (16) (n=6)

N-methyl morphinone (40 μL, 0.36 mmol) was added to a stirred solutionof 2-cyclohexyl-2-phenylglycolic acid (12) (35.5 mg, 0.15 mmol) and4-(mPEG₆ ethylamino)-but-2-yn-1-ol (8) (n=6) (45 mg, 0.12 mmol) inanhydrous DMF (2 mL) at room temperature. 1-Hydroxybenzotriazole (HOBt)(28.4 mg, 0.21 mmol) was added. The mixture was stirred at roomtemperature for 30 minutes, N,N′-dicyclohexylcarbodiimide (32.5 mg, 0.16mmol) was added. The resulting mixture was stirred at room temperaturefor 20 hours. Water was added to quench the reaction. The mixture wasextracted with EtOAc (3×15 mL). The combined organic solution was washedwith brine (2×30 mL), dried over Na₂SO₄, and concentrated. The residuewas purified with flash column chromatography on silica gel using 0-10%MeOH/dichloromethane to afford the product (16) (n=6) (25 mg). ¹H-NMR(500 MHz, CDCl₃): δ 7.65-7.63 (m, 2H), 7.35-7.32 (m, 2H), 7.27-7.25 (m,1H), 4.84-4.70 (m, 2H), 3.65-3.58 (m, 18H), 3.55-3.52 (m, 4H), 3.47 (m,2H), 3.37 (s, 3H), 2.63 (t, J=6.0 Hz, 2H), 2.49 (q, J=7.0 Hz, 2H), 2.25(m, 1H), 2.04 (br, s, 1H), 1.79-1.77 (m, 1H), 1.64 (m, 1H), 1.54-1.52(m, 2H), 1.46-1.38 (m, 1H), 1.35-1.26 (m, 1H), 1.20-1.06 (m, 4H), 1.02(t, J=7.0 Hz, 3H). LC-MS: 608.3 (MH⁺).

Synthesis of Cyclohexyl Hydroxy Phenyl Acetic Acid 4-Hydroxy But-2-ynylEster (20)

Method I:

HOBt (135.7 mg, 1.0 mmol) was added a stirred solution of2-cyclohexyl-2-phenylglycolic acid 12 (240 mg, 1.0 mmol) and2-butyne-1,4-diol (87 mg, 1.0 mmol) in anhydrous DMF (7.0 mL), cooled to0° C. N-methyl morphinone (0.25 mL, 2.26 mmol) was added. The resultingmixture was stirred at 0° C. for 30 minutes. DCC (216.5 mg, 1.05 mmol)was added. The resulting mixture was stirred at 0° C. for 30 minutes,and then at room temperature for 21.5 hours. EtOAc (20 mL) was added andthe white precipitate removed by filtration. The organic solution wasseparated and the aqueous solution was extracted with EtOAc (2×25 mL).The combined organic solution was washed with brine, dried over Na₂SO₄,concentrated. The residue was separated with flash column chromatographyon silica gel using 0-20% EtOAc/hexane to afford the product (20) (50mg, 17% yield), along with cyclohexyl phenyl acetic acid4-(2-cyclohexyl-2-hydroxy-2-phenyl acetoxy)-but-2-ynyl ester (26) (99mg, 37% yield) (as shown in the following structure).

¹H-NMR (500 MHz, CDCl₃) for compound (20): δ 7.66-7.64 (m, 2H),7.37-7.34 (m, 2H), 7.30-7.27 (m, 1H), 4.87-4.72 (m, 2H), 4.29-4.27 (m,2H), 3.57 (s, 1H), 2.29-2.23 (m, 1H), 1.82-1.79 (m, 1H), 1.66-1.64 (m,2H), 1.54-1.51 (m, 1H), 1.47-1.39 (m, 1H), 1.37-1.29 (m, 1H), 1.22-1.07(m, 4H). LC-MS: 325.1 (M+Na⁺).

¹H-NMR (500 MHz, CDCl₃) for the side product—cyclohexyl phenyl aceticacid 4-(2-cyclohexyl-2-hydroxy-2-phenyl acetoxy)-but-2-ynyl este (26): δ7.64-7.62 (m, 4H), 7.36-7.3 (m, 4H), 7.30-7.26 (m, 2H), 4.84-4.68 (m,4H), 3.543 (s, 1H), 3.535 (s, 1H), 2.24 (m, 2H), 1.82-1.79 (m, 2H),1.66-1.65 (m, 4H), 1.52-1.47 (m, 2H), 1.44-1.38 (m, 2H), 1.22-1.07 (m,8H). LC-MS: 541.2 (M+Na⁺).

Method II:

A solution of 2-cyclohexyl-2-phenylglycolic acid (12) (579 mg, 2.47mmol) and 1,1′-carbonyldiimidazole (462 mg, 2.85 mmol) was stirred at50° C. for 5 hours, cooled to room temperature. The solution was addedto a stirred solution of 2-butyne-1,4-diol (1) (1.0085 g, 11.60 mmol)and triethylamine (2.0 mL, 14.28 mmol) in anhydrous DMF (15 mL) at −70°C. (isopropanol/dry ice) over 5 minutes. The resulting mixture wasstirred at −70° C. for one hour. The cooling bath was removed and thereaction mixture was allowed to warm up to room temperature andcontinued to stir at room temperature for 18 hours. Water was added toquench the reaction. The mixture was extracted with ethyl acetate (3×25mL). The combined organic solution was washed with brine (2×50 mL),dried over anhydrous sodium sulfate, concentrated. The residue wasseparated with flash column chromatography on silica gel using 0-5%methanol in dichloromethane to afford the product (20) (509 mg) in 68%yield, along with the side product—cyclohexyl phenyl acetic acid4-(2-cyclohexyl-2-hydroxy-2-phenyl acetoxy)-but-2-ynyl ester (26) (129mg, 20% yield).

Synthesis of Cyclohexyl Hydroxy Phenyl Acetic Acid 4-MethanesulfonyloxyBut-2-ynyl Ester (21) (X=OMs)

Cyclohexyl-hydroxy-phenyl-acetic acid 4-hydroxy but-2-ynyl ester (20)(277 mg, 0.92 mmol) was dissolved in dichloromethane (5 mL), cooled to0° C. Triethylamine (0.2 mL, 1.43 mmol) was added. Methanesulfonylchloride (75 μL, 0.96 mmol) was added dropwise with syringe. Theresulting mixture was stirred at 0° C. for 40 minutes, at roomtemperature for 19 hours. Water was added to quench the reaction. Smallof saturated sodium chloride (10 mL) was added. The organic phase wasseparated and the aqueous phase was extracted with dichloromethane (15mL). The combined organic solution was washed with brine, dried overanhydrous sodium sulfate, concentrated. The residue was separated withflash column chromatography on silica gel using 5-50% ethyl acetate inhexane to afford the product (21) (98 mg) in 28% yield, along with aside product, cyclohexy-hydroxy phenyl acetic acid4-[4-(2-cyclohexy-2-hydroxy-2-phenyl-acetoxy)-but-2-ynyl ester 27 (117mg, 43% yield) (as shown in the following structure).

¹H-NMR (500 MHz, CDCl₃) for compound 20: δ 7.63-7.61 (m, 2H), 7.36-7.33(m, 2H), 7.30-7.26 (m, 1H), 4.86-4.76 (m, 4H), 3.54 (s, 1H), 2.99 (s,3H), 2.27-2.22 (m, 1H), 1.82-1.79 (m, 1H), 1.66-1.64 (m, 2H), 1.50-1.39(m, 2H), 1.37-1.27 (m, 1H), 1.21-1.06 (m, 4H). LC-MS: 398.1 (M⁺+18), 403(M+Na⁺).

¹H-NMR (500 MHz, CDCl₃) for the side product 27: δ 7.66-7.64 (m, 4H),7.37-7.34 (m, 4H), 7.30-7.26 (m, 2H), 4.89-4.72 (m, 4H), 4.13 (t, J=2.0Hz, 4H), 3.58 (s, 2H), 2.30-2.24 (m, 2H), 1.83-1.80 (m, 2H), 1.66-1.65(m, 4H), 1.54-1.52 (m, 2H), 1.48-1.40 (m, 2H), 1.38-1.29 (m, 2H),1.22-1.08 (m, 8H).

Synthesis of mPEG₄-Oxybutynin (16) (n=4)

A mixture of the mesylate (21) (X=OMs) (98 mg, 0.26 mmol) and mPEG₄-NHEt(6) (n=4) (purity: 90.6%) (97 mg, 0.38 mmol) and potassium carbonate(113.8 mg, 0.82 mmol) in acetonitrile (3 mL) was stirred at roomtemperature for 65 hours. The reaction mixture was filtered and washedwith dichloromethane. The solution was concentrated at reduced pressure.The residue was purified with flash column chromatography on silica gelusing 0-10% methanol in dichloromethane to afford the product (104 mg)in 77% yield as oil. ¹H-NMR (500 MHz, CDCl₃): δ 7.65-7.64 (m, 2H),7.35-7.32 (m, 2H), 7.28-7.25 (m, 1H), 4.84-4.70 (m, 2H), 3.66-3.59 (m,11H), 3.56-3.53 (m, 4H), 3.46 (m, 2H), 3.38 (s, 3H), 2.62 (t, J=6.0 Hz,2H), 2.49 (q, J=7.0 Hz, 2H), 2.28-2.23 (m, 1H), 1.80-1.77 (m, 1H), 1.64(m, 1H), 1.55-1.52 (m, 2H), 1.47-1.38 (m, 1H), 1.35-1.26 (m, 1H),1.20-1.06 (m, 4H), 1.02 (t, J=7.0 Hz, 3H). LC-MS: 520.2 (MH⁺).

Structure (16) having a variety of oligomer sizes can be prepared usingthe same approach but substituting an oligomer having a different size.

What is claimed is:
 1. A compound having the following structure:

wherein: R¹ is selected from the group consisting of H, OH, cyclopentyl,1-hydroxyl cyclopentyl, cyclohexyl and phenyl; R³ is selected from thegroup consisting of H, OH, cyclopentyl, 1-hydroxyl cyclopentyl,cyclohexyl and phenyl; with the proviso that at least one of R¹ and R³is selected from the group consisting of cyclopentyl, 1-hydroxylcyclopentyl, cyclohexyl and phenyl; L² is selected from the groupconsisting of hydrocarbon linkers of 2-4 carbons, heterocyclo linkers,and bihetereocyclo linkers; R⁴ is selected from the group consisting of—CH₃ and —CH₂CH₃; R⁵ is selected from the group consisting of —CH₃ and—CH₂CH₃; X is a spacer moiety; and POLY is a water-soluble, non-peptidicoligomer, and charged species of the compound.
 2. The compound of claim1, wherein R¹ is cyclohexyl and R³ is phenyl.
 3. The compound of claim1, wherein L² is —CH₂—C≡C—CH₂—.
 4. The compound of claim 1, wherein thewater-soluble, non-peptidic oligomer is a poly(alkylene oxide).
 5. Thecompound of claim 4, wherein the poly(alkylene oxide) is a poly(ethyleneoxide).
 6. The compound of claim 5, wherein the spacer moiety is acovalent bond.
 7. The compound of claim 5, wherein the spacer moiety is—O—.
 8. The compound of claim 2, wherein the water-soluble, non-peptidicoligomer is a poly(alkylene oxide).
 9. The compound of claim 8, whereinthe poly(alkylene oxide) is a poly(ethylene oxide).
 10. The compound ofclaim 9, wherein the spacer moiety is a covalent bond.
 11. The compoundof claim 9, wherein the spacer moiety is —O—.
 12. The compound of claim3, wherein the water-soluble, non-peptidic oligomer is a poly(alkyleneoxide).
 13. The compound of claim 12, wherein the poly(alkylene oxide)is a poly(ethylene oxide).
 14. The compound of claim 13, wherein thespacer moiety is a covalent bond.
 15. The compound of claim 13, whereinthe spacer moiety is —O—.
 16. The compound of claim 2, wherein L² is—CH₂—C≡C—CH₂— and the water-soluble, non-peptidic oligomer is apoly(alkylene oxide).
 17. The compound of claim 16, wherein thepoly(alkylene oxide) is a poly(ethylene oxide).
 18. The compound ofclaim 17, wherein the spacer moiety is a covalent bond.
 19. The compoundof claim 17, wherein the spacer moiety is —O—.
 20. The compound of claim1, wherein the water-soluble, non-peptidic oligomer has between 1 and 30monomers.
 21. The compound of claim 5, wherein the water-soluble,non-peptidic oligomer has between 1 and 10 monomers.
 22. The compound ofclaim 9, wherein the water-soluble, non-peptidic oligomer has between 1and 10 monomers.
 23. The compound of claim 13, wherein thewater-soluble, non-peptidic oligomer has between 1 and 10 monomers. 24.The compound of claim 17, wherein the water-soluble, non-peptidicoligomer has between 1 and 10 monomers.
 25. The compound of claim 4,wherein the poly(alkylene oxide) includes an alkoxy or hydroxyend-capping moiety.
 26. A composition comprising a compound of claim 1,and optionally, a pharmaceutically acceptable excipient.
 27. Acomposition of matter comprising a compound of claim 1, wherein thecompound is present in a dosage form.